ObamaCare in Practice: An Update

The first year we had health insurance via the ACA, I updated y’all frequently and promised to keep doing so. I realize that’s a promise I didn’t keep. Now that the law’s very existence is threatened, it seems like a good time to share how it’s been going for us in the almost two years since my last post.

I’m listing here for comparison some numbers I just crunched from the three years we have been covered thus far.

2014

Premiums paid: $3,796.75

Physician Charges: $41,191.17

Prescriptions: $9,581.96

Our portion after insurance: $5,454.47

Total health care costs: $9,251.22

2015

Premiums paid: $7,558.68

Physician Charges: $10,083.20

Prescriptions: $7,603.03

Our portion after insurance: $2,668.16

Total health care costs: $10,226.84

2016 (to date)

Premiums paid: $7,239.24

Physician Charges: $16,849.10

Prescriptions: $6,492.23

Our portion after insurance: $2,613.13

Total health care costs: $10,452.37

You will probably notice a couple of things: Our premiums went UP, and our physician charges went DOWN.

Well, it’s no secret that premiums are going up across the land, which many people blame on ObamaCare. Ours would be unaffordable by now if it weren’t for the generous government subsidy we receive thanks to the size of our family vs. the size of our income.

Our physician charges went down because for one thing we didn’t have a major medical issue as we did the first year when Jake required surgery for a severed tendon, and the first year we also all went to the doctor a lot to make up for years of not being able to do so. One of the things that has been driving costs up has been exactly this–people who hadn’t been able to access care, some of them very sick as a result, finally getting the care they need. Presumably some of that will improve as time goes on, as it has for us.

So our experience continues to be positive. We love our doctors. We love that we can still provide insurance for our two adult children who are not in school. We love that whenever anyone is sick we don’t have to worry about paying for or accessing care. We love having regular preventive care and psychological care too. And we love the lack of sticker shock at the pharmacy.

None of that is to say that there aren’t problems that need to be fixed. Because insurance companies now have to cover those who they used to be able to reject, they haven’t been able to make a profit for the past three years. Premiums continue to rise. And Blue Cross has pulled out of Knoxville so we have to find another plan for next year. Any day now I will have to devote a couple of hours to the hell on earth otherwise known as Healthcare.gov–which has only improved marginally since the last time I was there.

Now that I’ve got you all caught up, count on seeing more–a LOT more–on this topic over the next few weeks.

Even if it gets defunded or repealed that isn’t going to happen right away. So it’s definitely worthwhile to sign up–they would probably have it for at least a year. Also the more who sign up, the more it becomes clear to the administration how much it is needed. It creates more potentially unhappy constituents for Congress to consider as well. Please tell your friends to sign up. If they want their care to start at the first of next year they need to sign up my mid-December. They will need to go to healthcare.gov to begin the process. It’s not exactly hard but it’s cumbersome and they should expect to spend an hour on it. They will need the Social Security Numbers and income for everyone they are applying for.

It has worked out great for those that go to the doctor and have prescriptions. But for those of us don’t we just have to eat the increased premiums, or take the tax hit.

In 2017 we are expected to pay over $10,000 in premiums for the cheapest available coverage for two adults and one child. That’s about $5,000 more than we were paying before it passed. My son goes for one checkup a year, with an increase in co-pay. Net increased cost $5000.

ACA forced everyone to have coverage of a certain level, but Wall Street still controls our medical care. Costs continue to increase because the companies (insurance, drug, hospitals, etc.) have to increase their profits every year.

We make too much to be able to receive premium assistance but the premiums for minimal coverage are more than we can afford. And there are millions of us in the same boat.

Thanks for sharing Leslie. ACA is far from perfect, but it has allowed people to get coverage who would otherwise not have any. And I do know that many people have been getting delayed medical care. If ACA or its equivalent is going to work long term, it needs to focus on prevention. Delaying health care for years usually means problems grow and it becomes much more expensive to fix.

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